| NPI | 1659688539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MD 17634) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MD 17634) |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2018-12-12 |